2. • SIDAVEERAPPA B. TUPPAD
– Assistant Professor
– Department of Psychiatric Nursing
– SIONS BAGALKOT
SIDAVEERAPPA B. TUPPAD
3. Definition of Crisis
Caplan (1964) defined, “Crisis is a
psychological disequilibrium in a person
who confronts a hazardous circumstances
that for him constitutes an important
problem which he can for the time being
neither escape nor solve with his
customary problem solving resources”.
SIDAVEERAPPA B. TUPPAD
4. Characteristics of Crisis
• Crisis occurs in all individuals at one time or the
other.
• Crisis are precipitated by specific events of actual
or perceived losses, threats of losses.
• Crisis are personal by nature. What may be
considered as a crisis situation for one, may not
be for other.
• Crisis are acute, not chronic and will be resolved
in one way or another within a brief period.
SIDAVEERAPPA B. TUPPAD
5. Characteristics of Crisis-Contd.
• There is a disorganization of biological,
cognitive, emotional and behavioral
experiences.
• Person in crisis becomes less able to solve
problems.
SIDAVEERAPPA B. TUPPAD
6. Types of Crisis
• Situational Crisis: Results from an external
event or environment influences that upsets the
individual. Eg. A diagnosis of terminal illness, an
accident.
• Maturational Crisis: Are developmental events
along with growth and development. Eg. Erik
Erickson's developmental tasks – transition from
being a student to an employee, entering
marriage, becoming a parent, beginning
menopause etc.,
SIDAVEERAPPA B. TUPPAD
7. Types of Crisis-Contd.
• Adventitious Crisis: Is an accidental,
uncommon and unexpected tragedies that
disrupt entire communities. Eg. Fires,
Flood, Earthquake.
• Socio-Cultural Crisis: Arises from cultural
values that are embedded in the social
structure. Eg. Job loss due to deviant acts
that violates social structure such as
robbery, rape, murder etc.,
SIDAVEERAPPA B. TUPPAD
8. Phases of Crisis
• Phase I : The individual is exposed to a
precipitating stressor. Anxiety increases.
Previous problem solving techniques are
employed.
• Phase II: If the problem is not solved, anxiety
increases. Individual feels great deal of
discomfort, weak and vulnerable. Coping
techniques that have worked in the past are
attempted.
SIDAVEERAPPA B. TUPPAD
9. Phases of Crisis – Contd.
• Phase III: All possible resources both
internal and external are called on to
resolve the problem. Individual may try to
view the problem from a different
perspective or even overlook certain
aspects of it. New problem solving
techniques may be used.
SIDAVEERAPPA B. TUPPAD
10. Phases of Crisis – Contd.
• Phase IV: If resolution does not occur,
tension mounts beyond a further threshold
or its burden increases over time to a
breaking point. Major disorganization of
the individual with drastic results often
occurs. Anxiety may reach panic levels.
Cognitive functions are disordered.
Emotions are labile and behavior may
reflect the presence of psychotic thinking.
SIDAVEERAPPA B. TUPPAD
11. Principles of Crisis Intervention
• Even well adjusted person faces crisis.
Stress tolerance varies among individuals.
• Emotional crisis are self-limiting events
and resolution takes place within 4-6
weeks.
• Individual on crisis uses coping strategies
that were used during earlier crisis.
• Every crisis management is an additional
learning.
SIDAVEERAPPA B. TUPPAD
12. Principles of crisis intervention –
Contd.
• Adaptive crisis resolution in the past
interferes the crisis resolution process of
the present.
• Small external resource influences
disproportionate changes in behavior.
• All the time previous adaptive crisis
resolution are not useful.
SIDAVEERAPPA B. TUPPAD
13. Principles of crisis intervention –
Contd.
• Inherent in every crisis, is an actual or an
anticipated loss to the individual that must
be reconciled.Every crisis resolution is an
interpersonal event.
• Effective crisis resolution prevents future
crisis.
SIDAVEERAPPA B. TUPPAD
14. Techniques of Crisis
Intervention
• Abreaction: It is the release of feelings that
takes place as the individual talks about
emotionally changed areas.
• Clarification: It is encouraging the client to
express more clearly the relationship between
certain events in his life.
• Suggestion: It is influencing the client to
accept an idea or belief that he will feel better.
SIDAVEERAPPA B. TUPPAD
15. Techniques of Crisis
Intervention-Contd.
• Manipulation: It is using the client’s emotions,
wishes or values to his benefit in the therapeutic
process.
• Reinforcement behavior: It is giving the client
positive responses to adaptive behavior.
• Support of defenses: Encouraging the use of
healthy, adaptive defenses and discouraging
unhealthy or maladaptive coping behavior.
SIDAVEERAPPA B. TUPPAD
16. Techniques of Crisis
Intervention-Contd.
• Raising self esteem: It is to help client to
regain feelings of self worth.
• Exploration of solutions: It is examining
alternative ways of solving the immediate
problems.
SIDAVEERAPPA B. TUPPAD
17. Process of Crisis Intervention
• Goal: To resolve immediate crisis. Restore
and bring the level of functioning to the
precrisis state.
SIDAVEERAPPA B. TUPPAD
18. Process of Crisis Intervention
- Contd.
• Assessment:
-Identify the precipitating event.
-Explore the client’s perception of the
event.
-Recognize the nature and strength of the
client’s support system.
-Find out the client’s previous strengths
and coping mechanisms.
SIDAVEERAPPA B. TUPPAD
19. Process of Crisis Intervention
- Contd.
• Intervention:
- Environmental manipulation.
- General support.
- Generic approach.
- Individual approach.
SIDAVEERAPPA B. TUPPAD
20. Process of Crisis Intervention
- Contd.
• Environmental manipulation: It is directly
changing the client’s physical environment or
psychological situation.
• General support: Extending the psychological
and physical assistance to solve problems. Eg.
Leg amputed patient is encouraged for
mobilization with warmth, acceptance,
empathy, caring and reassurance.
SIDAVEERAPPA B. TUPPAD
21. Process of Crisis Intervention
- Contd.
• Generic approach: It is to reach high-risk
individuals and implement mapped out solutions to
reach precrisis stage.
Eg. Intervention to Disaster victims.
• Individual approach: It is application of specific
intervention to a specific problem in a specific
client.
Eg. One to one counseling at the time of labor pain
SIDAVEERAPPA B. TUPPAD
22. Trends in Crisis Intervention
• On-Sight crisis counseling.
• Mobile out reach.
• Telephone counseling and Hot line. Eg. Suicide
prevention through telephone counseling ,
Battered women’s Hot line.
• Disaster response and critical incident stress
debriefing.
• Group work.
• Health education.
SIDAVEERAPPA B. TUPPAD
